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au:Cordeiro, André Luiz Lisboa

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Recruitment maneuvers in patients with acute respiratory distress syndrome: a systematic review and metanalysis syndrome
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Jesus, Alice Cardoso de

; Figueiredo, Arthur Marchesini de

; Cordeiro, André Luiz Lisboa

einstein (São Paulo)

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2024, Volume 22 elocation eRW0372

Resumo: En | Texto: En | PDF: En

ABSTRACT Objective: To systematically review the effects of recruitment maneuvers on patients with acute respiratory distress syndrome. Methods: This systematic review and meta-analysis using the PICO methodology with keywords (respiratory distress syndrome, recruitment maneuvers, lung recruitment, acute respiratory distress syndrome, alveolar recruitment, and adult acute respiratory distress syndrome). Studies involving patients >18 years, regardless of sex, with acute respiratory distress syndrome, mechanically ventilated for at least 24 h, published in English, Portuguese, and Spanish, with no year restrictions, were included. Studies that combined recruitment maneuvers with other techniques and those conducted in animals were excluded. Boolean operators "AND" and "OR" were used. Results: Fifteen studies were included. The recruitment maneuver proved to be effective in oxygenating patients (mean difference=45.05 mmHg (95% confidence interval (95%CI): 31.37-58.74)), but there was no statistically significant difference in the rate of mortality OR=0.89 (95%CI=0.74-1.08) and barotrauma RR=0.93 (95%CI=0.56-1.54). Conclusion: Recruitment maneuvers should not be used routinely in the care of patients with acute respiratory distress syndrome, but it is a good rescue strategy when other methods fail to improve oxygenation. Prospero database registration: (www.crd.york.ac.uk/prospero) under ID CRD42021227231. Objective syndrome Methods metaanalysis meta analysis . syndrome) 18 >1 years sex 2 h English Portuguese Spanish restrictions included excluded AND "AND OR "OR Results mean difference4505 45 05 difference=45.0 95% 95 (95 95%CI 95CI CI (95%CI) 31.3758.74, 31375874 31.37 58.74 , 31 37 58 74 31.37-58.74)) OR089 0 89 OR=0.8 95%CI=0.741.08 95CI074108 95%CI=0.74 1.08 1 08 (95%CI=0.74-1.08 RR093 RR 93 RR=0.9 95%CI=0.561.54. 95CI056154 95%CI=0.56 1.54 56 54 (95%CI=0.56-1.54) Conclusion oxygenation registration www.crd.york.ac.uk/prospero wwwcrdyorkacukprospero www crd york ac uk prospero (www.crd.york.ac.uk/prospero CRD42021227231 CRD > difference450 4 difference=45. 9 (9 (95%CI 3758 31.3758.74 3137587 3137 31.3 5874 58.7 3 5 7 31.37-58.74) OR08 8 OR=0. 741 95%CI=0.741.0 95CI07410 95CI074 95%CI=0.7 108 1.0 (95%CI=0.74-1.0 RR09 RR=0. 561 95%CI=0.561.54 95CI05615 95CI056 95%CI=0.5 154 1.5 (95%CI=0.56-1.54 CRD4202122723 difference45 difference=45 ( 375 31.3758.7 313758 313 31. 587 58. 31.37-58.74 OR0 OR=0 95%CI=0.741. 95CI0741 95CI07 95%CI=0. 10 1. (95%CI=0.74-1. RR0 RR=0 95%CI=0.561.5 95CI0561 95CI05 15 (95%CI=0.56-1.5 CRD420212272 difference4 difference=4 31.3758. 31375 31.37-58.7 OR= 95%CI=0.741 95CI0 95%CI=0 (95%CI=0.74-1 RR= 95%CI=0.561. (95%CI=0.56-1. CRD42021227 difference= 31.3758 31.37-58. 95%CI= (95%CI=0.74- 95%CI=0.561 (95%CI=0.56-1 CRD4202122 31.375 31.37-58 (95%CI=0.74 (95%CI=0.56- CRD420212 31.37-5 (95%CI=0.7 (95%CI=0.56 CRD42021 31.37- (95%CI=0. (95%CI=0.5 CRD4202 (95%CI=0 CRD420 (95%CI= CRD42 CRD4

https://doi.org/10.31744/einstein_journal/2024rw0372

Feasibility of the Two-Minute Walk Test in Elderly Patients After Acute Myocardial Infarction: A Cross-Sectional Study TwoMinute Two Minute Infarction CrossSectional Cross Sectional
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Cordeiro, André Luiz Lisboa

; Santos, Luiz Anselmo

; Oliveira, Lucas

; Almeida, Ana Cristina

; Alves, Damaris

; Silva, Hanna Beatriz de Melo Moraes e

; Souza, Fernanda Francisco

; Guimarães, André Raimundo França

International Journal of Cardiovascular Sciences

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2024, Volume 37 elocation e20240023

Resumo: En | Texto: En | PDF: En

Abstract Background Pathologies involving the heart are still the main causes of death, and acute myocardial infarction (AMI) is consistently present in this index. The two-minute walk test (2MWT) is ideal for assessing the functional capacity of this patient. Objective To describe the feasibility of the 2MWT in older people after AMI. Methods This is a cross-sectional study. At hospital discharge, patients were invited to perform the 2MWT. Before starting the test, systolic blood pressure (SBP), diastolic blood pressure (DBP), peripheral oxygen saturation (SpO2), heart rate (HR) and the Double Product (DP) were checked. After checking the vital signs, the patients were accompanied by an examiner, who was positioned laterally to ensure safety and verbally encouraged during the test; after the completion of the test, all vital signs were reassessed in two moments, at the immediate end and after 20 minutes of rest. ANOVA was used for the comparison of pre and post-test and pre and recovery. A p<0.05 was considered significant. Results We evaluated 51 patients, 4 (80%) males with a mean age of 67±8 years. The distance walked on the 2MWT had a mean of 157 ± 22 meters. The SBPmmHg Pre-Test 112±21 vs 131±15 Post-Test (p=0.24) and 119±22 at Recovery (p = 0.34) and HR (bpm) Pre-Test 75±15 vs 89±19 Post-Test (p=0.15) and 79±15 at Recovery (p = 0.59). After a rest, all variables analyzed followed the same pattern, returning to values close to the pre-test moment. Conclusion The performance of the 2MWT in the hospital environment presents good feasibility in the evaluation of submaximal capacity in elderly patients after AMI. death AMI (AMI index twominute minute MWT (2MWT patient crosssectional cross sectional study discharge SBP, SBP , (SBP) DBP, DBP (DBP) SpO2, SpO2 SpO (SpO2) (HR DP (DP checked examiner moments 2 rest posttest post recovery p005 p 0 05 p<0.0 significant 5 80% 80 (80% 678 67 8 67± years 15 meters PreTest Pre Test 11221 112 21 112±2 13115 131 131±1 PostTest Post p=0.24 p024 24 (p=0.24 11922 119 119±2 0.34 034 34 bpm (bpm 7515 75 75±1 8919 89 19 89±1 p=0.15 p015 (p=0.15 7915 79 79±1 0.59. 059 0.59 . 59 0.59) pattern pretest moment (SBP (DBP (SpO2 p00 p<0. (80 6 1 1122 11 112± 1311 13 131± p=0.2 p02 (p=0.2 1192 119± 0.3 03 3 751 7 75± 891 89± p=0.1 p01 (p=0.1 791 79± 0.5 (SpO p0 p<0 (8 p=0. (p=0. 0. p< ( p=0 (p=0 p= (p=

https://doi.org/10.36660/ijcs.20240023

Functional performance of patients submitted to cardiac surgery with different levels of sleep quality: an observational study quality
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Cordeiro, André Luiz Lisboa

; Barbosa, Hayssa de Cássia Mascarenhas

; Mascarenhas Junior, Daniel Silva

; Santos, Jandesson Cena dos

; Guimarães, André Raimundo França

Brazilian Journal of Otorhinolaryngology

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2024, Volume 90 Nº 6 elocation 101497

Resumo: En | Texto: En | PDF: En

Abstract Objective: To describe pulmonary function, muscle strength and functional performance in the different qualities of sleep and the impact of this on the number of physiotherapeutic assistances. Methods: This is an observational study. In the pre and post operative period, sleep behavior was evaluated using the Pittsburgh questionnaire. Patients were divided into three groups: Good Sleep Quality (GSQ), Poor Sleep Quality (PSQ) and Sleep Disordered (SDB). At this time, other tests were also performed, such as: 6-Minute Walk Test (6MWT), Sit and Stand Test (SST), gait speed test and Timed Up to Go (TUG), Medical Research Council (MRC), maximal inspiratory pressure and maximal expiratory, vital capacity and peak expiratory flow. The functional performance and lung function of each group were compared. Results: A total of 105 people, undergoing cardiac surgery and admitted to hospital were evaluated, 33 with GSQ, 41 with PSQ and 31 with SD. Patients who were in the SDB group had a lower functional performance than the other groups. 6MWT (meters) in the GSQ was 499±87, versus 487±91 in the PSQ and 430±78 in the SD (p = 0.02). In the SST (seconds) it was 10.4±1.1 in the GQS, 11.1±2.3 in the PSQ and 15.4±2.1 in the SD (p = 0.04). Lung function and muscle strength did not differ between groups. Regarding the refusal to perform physical therapy, the SD group was more incident, the main reason being drowsiness. Conclusion: Based on the results, we found that sleep quality interferes with functional performance and physical therapy assistance during the hospital stay in patients undergoing cardiac surgery. Objective assistances Methods study period questionnaire groups , (GSQ) (PSQ SDB. . (SDB) time performed as 6Minute Minute 6 6MWT, MWT (6MWT) SST, (SST) TUG, TUG (TUG) MRC, MRC (MRC) flow compared Results 10 people 3 4 meters (meters 49987 499 87 499±87 48791 487 91 487±9 43078 430 78 430±7 p 0.02. 002 0.02 0 02 0.02) seconds (seconds 10411 1 10.4±1. GQS 11123 11 2 11.1±2. 15421 15 15.4±2. 0.04. 004 0.04 04 0.04) incident drowsiness Conclusion results (GSQ (SDB (6MWT (SST (TUG (MRC 4998 49 8 499±8 4879 48 9 487± 4307 43 7 430± 00 0.0 1041 10.4±1 1112 11.1±2 1542 15.4±2 499± 0. 104 10.4± 111 11.1± 154 15.4± 10.4 11.1 15.4 10. 11. 15.

https://doi.org/10.1016/j.bjorl.2024.101497

Evaluation and Comparison of Respiratory Muscular Strength, Functionality, and Pelvic Floor in the Immediate Postpartum of Normal and Cesarean Birth Strength Functionality
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Rosa, Carolina Martins da

; Dockhorn, Thariny Huesken

; Cardoso, Juliana Rezende

; Forgiarini, Soraia Genebra Ibrahim

; Forgiarini Junior, Luiz Alberto

; Cordeiro, André Luiz Lisboa

Revista Brasileira de Ginecologia e Obstetrícia

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Mar 2023, Volume 45 Nº 3 Páginas 121 - 126

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Objetivo: Avaliar e comparar o pavimento pélvico periférico, a força muscular respiratória e a funcionalidade no puerpério imediato do parto normal e da cesariana. Métodos: Este é um estudo transversal que verificou a força muscular respiratória, pavimento pélvico, periférico e funcional através da manovacuometria, avaliação funcional do pavimento pélvico (PFF), dinamometria, e o teste Time Up e Go (TUG), respectivamente. Os grupos foram divididos de acordo com o tipo de parto, num grupo de cesariana e num grupo de parto normal. Resultados: A amostra foi composta por 72 puérperas pós-parto, 36 de parto normal e 36 de cesariana, avaliados antes da alta hospitalar, a idade média variou entre 25,56 ± 6,28 e 28,57 ± 6,47 anos em puérperas de parto normal e cesariana, respectivamente. A cesariana mostrou maior resistência do pavimento pélvico (TFP) em comparação com o parto normal (p < 0,002), mas as puérperas de parto normal mostraram melhor funcionalidade (p < 0,001). Quanto à força muscular periférica e à força muscular respiratória, não houve significado ao comparar os tipos de parto. Conclusão: Há uma redução da força muscular pélvica em puérperas de parto normal e uma diminuição da funcionalidade em puérperas de cesarianas. Objetivo Métodos manovacuometria PFF, PFF , (PFF) dinamometria TUG, TUG (TUG) respectivamente Resultados 7 pósparto, pósparto pós pós-parto 3 hospitalar 2556 25 56 25,5 628 6 28 6,2 2857 57 28,5 647 47 6,4 TFP (TFP p 0,002, 0002 0,002 0 002 0,002) 0,001. 0001 0,001 . 001 0,001) Conclusão cesarianas (PFF (TUG 255 2 5 25, 62 6, 285 28, 64 4 000 0,00 00 0,0 0,

Abstract Objective: To evaluate and compare peripheral, pelvic floor, respiratory muscle strength, and functionality in the immediate puerperium of normal delivery and cesarean section. Methods: This is a cross-sectional study that verified respiratory, pelvic floor, peripheral, and functional muscle strength through manovacuometry, pelvic floor functional assessment (PFF), dynamometry, and the Time Up and Go (TUG) test, respectively. The groups were divided according to the type of delivery, into a cesarean section group and a normal parturition group. Results: The sample was composed of 72 postpartum puerperae, 36 of normal parturition, and 36 of cesarean section, evaluated before hospital discharge, mean age ranged from 25.56 ± 6.28 and 28.57 ± 6.47 years in puerperae of normal parturition and cesarean section respectively. Cesarean showed higher pelvic floor strength (PFF) compared to normal parturition (p < 0.002), but puerperae from normal delivery showed better functionality (p < 0.001). As for peripheral muscle strength and respiratory muscle strength, there was no significance when comparing the types of parturirion. Conclusion: There is a reduction in pelvic muscle strength in puerperae of normal delivery and a decrease in functionality in puerperae of cesarean section. Objective Methods crosssectional cross sectional manovacuometry PFF, PFF , dynamometry TUG (TUG test respectively Results 7 3 discharge 2556 25 56 25.5 628 6 28 6.2 2857 57 28.5 647 47 6.4 (PFF p 0.002, 0002 0.002 0 002 0.002) 0.001. 0001 0.001 . 001 0.001) parturirion Conclusion 255 2 5 25. 62 6. 285 28. 64 4 000 0.00 00 0.0 0.

https://doi.org/10.1055/s-0043-1768457

Ventilatory Muscle Strength Six Months After Coronary Artery Bypass Grafting in Patients Submitted to Inspiratory Muscular Training Based on Anaerobioc Threshold: A Clinical Trial Threshold
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Cordeiro, André Luiz Lisboa

; Almeida, Larissa Costa

; Leite, Jackeline Ferreira Dos Santos

; Barbosa, Hayssa de Cássia Mascarenhas

; Guimarães, André Raimundo França

; Forgiarini Junior, Luiz Alberto

; Cena, Jandesson

; Petto, Jefferson

International Journal of Cardiovascular Sciences

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2023, Volume 36 elocation e20210238

Resumo: En | Texto: En | PDF: En

Abstract Introduction Coronary artery bypass grafting (CABG) surgery is associated with a decline in ventilatory muscle strength and lung function. Inspiratory muscle training (IMT) based on anaerobic threshold (AT) has been used to minimize the impact of CABG on these parameters, but the long-term impact is unknown. Objective To test the hypothesis that AT-based IMT improves inspiratory muscle strength and lung function even six months after CABG. Methods This is a randomized controlled clinical trial. In the preoperative period, maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), vital capacity (VC) and peak expiratory flow (PEF) rate were assessed. On the first postoperative day, patients were randomized into two groups: AT-based IMT (IMT-AT) (n=21) where the load was prescribed based on glycemic threshold and conventional IMT (IMT-C) (n=21), with load of 40% of MIP. Patients were trained during hospitalization until the day of discharge and were assessed at discharge and six months later. For within-group comparison, paired Student's t-test or Wilcoxon test was used, and independent Student's t-test or the Mann-Whitney test was used to analyze the different time points. A p<0.05 was considered significant. Results At six months after CABG surgery, statistical difference was found between the IMT-AT and the IMT-C groups in MIP (difference between the means of -5cmH2; 95% CI=- 8.21to-1.79) and VC (difference between the means of -2ml/kg;95%CI=-3.87to-0.13). No difference was found between groups in the other variables analyzed. Conclusion IMT-AT promoted greater recovery of inspiratory muscle strength and VC after six months of CABG when compared to conventional training. (CABG (IMT AT (AT parameters longterm long term unknown ATbased trial period MIP, , (MIP) MEP, MEP (MEP) (VC PEF (PEF IMTAT (IMT-AT n=21 n21 n 21 (n=21 IMTC C (IMT-C n=21, 40 later withingroup within group comparison Students Student s ttest t MannWhitney Mann Whitney points p005 p 0 05 p<0.0 significant 5cmH2 cmH -5cmH2 95 CI= CI 8.21to1.79 821to179 8.21to 1.79 8 21to 1 79 8.21to-1.79 2ml/kg95%CI=3.87to0.13. 2mlkg95CI387to013 mlkgCIto 2ml/kg 95%CI= 3.87to 0.13 . 2ml kg 3 87to 13 ml -2ml/kg;95%CI=-3.87to-0.13) analyzed (MIP (MEP n=2 n2 2 (n=2 4 p00 p<0. 5cmH -5cmH 9 21to1 8.21to1.7 821to17 821to 179 1.7 7 8.21to-1.7 kg95 87to0 2ml/kg95%CI=3.87to0.13 mlkg 2mlkg95CI387to01 2mlkg 95CI 95%CI 387to 013 0.1 -2ml/kg;95%CI=-3.87to-0.13 n= (n= p0 p<0 8.21to1. 821to1 17 1. 8.21to-1. kg9 2ml/kg95%CI=3.87to0.1 2mlkg95CI387to0 01 0. -2ml/kg;95%CI=-3.87to-0.1 (n p< 8.21to1 8.21to-1 2ml/kg95%CI=3.87to0. 2mlkg95CI387to -2ml/kg;95%CI=-3.87to-0. 8.21to- 2ml/kg95%CI=3.87to0 -2ml/kg;95%CI=-3.87to-0 2ml/kg95%CI=3.87to -2ml/kg;95%CI=-3.87to- -2ml/kg;95%CI=-3.87to

https://doi.org/10.36660/ijcs.20210238

Pilates method on pain in patients with low back pain: systematic review
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Cordeiro, André Luiz Lisboa

; Oliveira, Ana Paula Silva

; Cerqueira, Natale Sena

; Santos, Fernanda Aparecida Ferreira

; Oliveira, Alberto Manoel Sarkis

BrJP

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Set 2022, Volume 5 Nº 3 Páginas 265 - 271

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

RESUMO JUSTIFICATIVA E OBJETIVOS: A fraqueza dos extensores de tronco é uma das principais causas no desenvolvimento de lombalgia em grande parte da população. A dor lombar é uma condição incapacitante e, devido à dor, muitas pessoas têm dificuldade para realizar as atividades de vida diária. Assim, o Pilates passa a ser um dos métodos de escolha para tratamento de pacientes com lombalgia, pois traz exercícios de fortalecimento muscular que promovem estabilização da coluna vertebral. O objetivo deste estudo foi analisar o impacto do método Pilates na dor de pacientes com lombalgia crônica. METODOS: Trata-se de uma revisão sistemática com busca de estudos nas bases de dados Scielo, OVID, Lilacs, Pubmed e PEDro incluindo ensaios clínicos randomizados que abordaram o método Pilates em pacientes com lombalgia crônica inespecífica. Os descritores de busca utilizados foram low back pain, Pilates method, exercise movement techniques, somados aos operadores booleanos: “e” e “ou”. O risco de viés dos estudos foi avaliado de acordo com os critérios da escala PEDro. RESULTADOS: Dos 8 estudos selecionados, todos obtiveram resultados positivos na redução da dor lombar, cada um utilizando um protocolo diferente associado ao tratamento de fisioterapia. Dos oito estudos considerados elegíveis, apenas sete foram incluídos na meta-análise. Para a meta-análise desta comparação, foi utilizado um modelo randomizado (I2=92%, df=6, p=0,01), no qual houve uma diferença estatisticamente significativa entre os grupos Pilates e grupo controle (95% CI -1,79, -0,19). CONCLUSÃO: Foi possível concluir que o método Pilates foi eficaz no tratamento de dores lombares. DESTAQUES O estudo reforça a importância do método Pilates para pacientes com dor lombar, concentrando-se na redução da dor, mas com um impacto na funcionalidade e qualidade de vida. O papel do Pilates como parte integrante de um protocolo de tratamento também é reforçado, não sendo a única ferramenta para o tratamento fisioterápico. A aplicação do método Pilates deve começar com exercícios de dificuldade leve a moderada e, após o ganho funcional, progredir para alta complexidade.

ABSTRACT BACKGROUND AND OBJECTIVES: The weakness of the trunk extensors is one of the main causes in the development of low back pain in a large part of the population. Low back pain is a disabling condition and due to the pain many people have difficulty performing activities of daily life. Thus, Pilates becomes one of the methods of choice in the treatment of low back pain because it brings muscle strengthening exercises that positively impact the stabilization of the spine. The objective of this study was to review the impact of the Pilates method on pain in patients with low back pain. METHODS: This is a systematic review, with search for data in the Scielo, OVID, Lilacs, Pubmed and PEDro databases, which included randomized clinical trials that addressed the Pilates method in patients with low back pain. The following search descriptors were used: low back pain, Pilates method, exercise movement techniques. The Boolean operators were: “and” and “or”. RESULTS: Of the 8 selected studies, all obtained positive results in the reduction of low back pain, each using a different protocol associated with physical therapy treatment. Of the eight studies considered eligible, only seven were included. For the study of this comparison, a random model was used (I2=92%, df=6, p=0.01), in which there was a statistically significant diference between the Pilates and control groups (95% CI -1.79, -0.19). CONCLUSION: It was possible to conclude that the Pilates method he was effective in the treatment of low back pain. HIGHLIGHTS The study reinforces the importance of the Pilates method for patients with low back pain, focusing on pain reduction, but with an impact on functionality and quality of life. The role of Pilates as an integral part of a care protocol is also reinforced, not as the only tool for physical therapy care. The application of Pilates method should begin with exercises of mild to moderate difficulty and, with functional gain, progress to high complexity.

https://doi.org/10.5935/2595-0118.20220038-en

Impact of drains positioning on pulmonary function after coronary artery bypass grafting: an observational study
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Gomes, Débora Santos de Oliveira

; Silva, Elzane Jesus de Almeida

; Silva, Josimar Silva e

; Barbosa, Hayssa de Cássia Mascarenhas

; Guimarães, André Raimundo

; Cordeiro, André Luiz Lisboa

Brazilian Journal of Anesthesiology

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Fev 2022, Volume 72 Nº 1 Páginas 83 - 87

Resumo: En | Texto: En | PDF: En

Abstract Introduction: Coronary artery bypass grafting (CABG) is a procedure associated with a decline in pulmonary function. Among the main causes is the presence of the drain that is usually positioned in the intercostal or subxiphoid region. Objective: To measure the interference of drains positioning on pulmonary function in patients undergoing CABG. Methods: Observational study that assessed preoperative pulmonary function through vital capacity (VC), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and peak expiratory flow (PEF). These variables were evaluated in three different moments: in the presence of two drains, when removing one, and after removing all drains. Results: We evaluated 45 patients with a mean age of 62 ± 7 years with male prevalence of 29 (64%) individuals. The insertion of drains caused a decline in pulmonary function after surgery by reducing MIP by 48%, MEP by 11%, VC by 39%, and PEF by 6%. Conclusion: This study has demonstrated that drains positioning after CABG surgery may produce weakness of the respiratory muscles, change ventilatory mechanics, and impair normal pulmonary function postoperatively.

https://doi.org/10.1016/j.bjane.2021.06.010

Cardiovascular Risk Factors, Functionality, and Quality of Life in Climacteric Women
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Chaves, João Vítor Costa dos Santos

; Pinto, Keila Lindineia Silva

; de Sousa, Kleicillainy Mota

; Soares, Lucas Oliveira

; Cordeiro, André Luiz Lisboa

International Journal of Cardiovascular Sciences

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Ago 2021, Volume 34 Nº 4 Páginas 393 - 397

Resumo: En | Texto: En | PDF: En

Abstract Background: Cardiovascular disease (CVD) comprises a group of cardiac and circulatory diseases. Despite the high incidence in males, women after menopause have an exponential increase in the risk of CVD. Objective: To identify the leading risk factors for CVD and describe quality of life and functionality in women hospitalized for cardiac causes during the climacteric period. Materials and methods: Observational descriptive study. Quality of life was assessed through the SF-36 questionnaire, and functionality through the Functional Independence Measurement (FIM) scale. Records were used to identify the main risk factors associated with CVD in climacteric women. Results: We included 30 patients (mean age, 55 ± 6 years). The mean FIM score was 118 ± 3, and the mean SF-36 score, 20 ± 10. Hypertension and sedentary lifestyle were the most prevalent cardiovascular risk factors in these women. Conclusion: Hypertension and sedentary lifestyle were the most prevalent cardiovascular risk factors in this sample of climacteric women hospitalized for cardiac causes. Quality of life was strongly affected, with social, emotional, and mental health domains showing the most impact.

https://doi.org/10.36660/ijcs.20200410 3 downloads

Correlation between Surgical Risk Scales with Respiratory Muscle Strength and Functional Independence in Patients Submitted to Coronary Artery Bypass Grafting
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Cordeiro, André Luiz Lisboa

; Brito, Átila Darlan Queiroz de

; Almeida, Graziele Freitas

; Jesus, Leilane Souza

; Oliveira, Flávia de Araújo

; Silva, Janinne Lima da

; Guimarães, André Raimundo França

; Barros, Roberto Moreno

International Journal of Cardiovascular Sciences

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Fev 2021, Volume 34 Nº 1 Páginas 60 - 66

Resumo: En | Texto: En | PDF: En

Abstract Background The European Heart Surgery Risk Assessment System (EuroSCORE) and InsCor have been used to predict complications of cardiac surgery. However, their application to predict lung function and functionality is still uncertain. Objective To correlate surgical risk scales with functional independence and pulmonary function in patients undergoing coronary artery bypass grafting. Methods This was a prospective cohort study. In the preoperative period, the two surgical scales were applied, the maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and peak expiratory flow (PEF) were measured, and functionality was assessed using the functional independence measure (FIM). On the seventh postoperative day, the pulmonary function and functionality variables were reevaluated, compared with the preoperative values (delta) and correlated with the risk scales. Correlations of pulmonary function, functional independence and muscle strength variables with the surgical scales were made by Pearson correlation test. The significance level adopted was 5%. Results Thirty-one patients were studied; most were male (77%), with a mean age of 56±8 years. Mean EuroSCORE was 2.3±0.5 and mean InsCOR was 1.2±0.5. MIP, MEP, and PEF reduced 30% (p<0.001), 33% (p<0.001) and 10% (p=0.23), respectively. The EuroSCORE correlated with MIP (r-0.78; p = 0.02) and FIM (r-0.79; p <0.01), and the InsCor correlated with MIP (r-0.77), MEP (r-0.73) and MIF (r-0.89; p=0.02). Conclusion The EuroSCORE showed a strong negative correlation with MIP and FIM, while InsCor had a strong negative correlation with MIP, MEP and FIM. (Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0)

https://doi.org/10.36660/ijcs.20190161 266 downloads

10.

Inspiratory Muscle Training Based on Anaerobic Threshold on the Functional Capacity of Patients After Coronary Artery Bypass Grafting: Clinical Trial
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Cordeiro, André Luiz Lisboa

; Mascarenhas, Hayssa de Cássia

; Landerson, Lucas

; Araújo, Jaclene da Silva

; Borges, Daniel Lago

; Melo, Thiago Araújo de

; Guimarães, André

; Petto, Jefferson

Brazilian Journal of Cardiovascular Surgery

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Dez 2020, Volume 35 Nº 6 Páginas 942 - 949

Resumo: En | Texto: En | PDF: En

Abstract Introduction: Coronary artery bypass grafting (CABG) is associated with reduced ventilatory muscle strength and consequent worsening of functional capacity (FC). Inspiratory Muscle Training (IMT) can be indicated, but there is still a lack of knowledge about the use of the anaerobic threshold (AT) as a basis for prescription. The objective of this study is to evaluate if IMT based on AT modifies FC and inspiratory muscle strength of patients submitted to CABG. Methods: This is a clinical trial. On the first postoperative day, the patients were divided into two groups: the conventional group (IMT-C), which performed IMT based on 40% of maximal inspiratory pressure (MIP), and the IMT-AT group, which performed IMT based on AT. All patients underwent preoperative and postoperative assessment of MIP and performed a six-minute walk test (6MWT). Results: Forty-two patients were evaluated, 21 in each group. Their mean age was 61.4±10 years and 27 (64%) of them were male. There was a reduction of inspiratory muscle strength with a delta of 23±13 cmH2O in the IMT-C group vs. 11±10 cmH2O in the IMT-AT group (P<0.01) and of the walking distance with a delta of 94±34 meters in the IMT-C group vs. 57±30 meters in the IMT-AT group (P=0.04). Conclusion: IMT based on AT minimized the loss of FC and inspiratory muscle strength of patients submitted to CABG.

https://doi.org/10.21470/1678-9741-2019-0448 471 downloads

11.

Epidemiologia e desfecho dos pacientes de alto risco cirúrgico admitidos em unidades de terapia intensiva no Brasil
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Silva Júnior, João Manoel

; Chaves, Renato Carneiro de Freitas

; Corrêa, Thiago Domingos

; Assunção, Murillo Santucci Cesar de

; Katayama, Henrique Tadashi

; Bosso, Fabio Eduardo

; Amendola, Cristina Prata

; Serpa Neto, Ary

; Malbouisson, Luiz Marcelo Sá

; Oliveira, Neymar Elias de

; Veiga, Viviane Cordeiro

; Rojas, Salomón Soriano Ordinola

; Postalli, Natalia Fioravante

; Alvarisa, Thais Kawagoe

; Lucena, Bruno Melo Nobrega de

; Oliveira, Raphael Augusto Gomes de

; Sanches, Luciana Coelho

; Silva, Ulysses Vasconcellos de Andrade e

; Nassar Junior, Antonio Paulo

; Réa-Neto, Álvaro

; Amaral, Alexandre

; Teles, José Mário

; Freitas, Flávio Geraldo Rezende de

; Bafi, Antônio Tonete

; Pacheco, Eduardo Souza

; Ramos, Fernando José

; Vieira Júnior, José Mauro

; Pereira, Maria Augusta Santos Rahe

; Schwerz, Fábio Sartori

; Menezes, Giovanna Padoa de

; Magalhães, Danielle Dourado

; Castro, Cristine Pilati Pileggi

; Henrich, Sabrina Frighetto

; Toledo, Diogo Oliveira

; Parra, Bruna Fernanda Camargo Silva

; Dias, Fernando Suparregui

; Zerman, Luiza

; Formolo, Fernanda

; Nobrega, Marciano de Sousa

; Piras, Claudio

; Piras, Stéphanie de Barros

; Conti, Rodrigo

; Bittencourt, Paulo Lisboa

; D’Oliveira, Ricardo Azevedo Cruz

; Estrela, André Ricardo de Oliveira

; Oliveira, Mirella Cristine de

; Reese, Fernanda Baeumle

; Motta Júnior, Jarbas da Silva

; Câmara, Bruna Martins Dzivielevski da

; David-João, Paula Geraldes

; Tannous, Luana Alves

; Chaiben, Viviane Bernardes de Oliveira

; Miranda, Lorena Macedo Araújo

; Brasil, José Arthur dos Santos

; Deucher, Rafael Alexandre de Oliveira

; Ferreira, Marcos Henrique Borges

; Vilela, Denner Luiz

; Almeida, Guilherme Cincinato de

; Nedel, Wagner Luis

; Passos, Matheus Golenia dos

; Marin, Luiz Gustavo

; Oliveira Filho, Wilson de

; Coutinho, Raoni Machado

; Oliveira, Michele Cristina Lima de

; Friedman, Gilberto

; Meregalli, André

; Höher, Jorge Amilton

; Soares, Afonso José Celente

; Lobo, Suzana Margareth Ajeje

Revista Brasileira de Terapia Intensiva

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Mar 2020, Volume 32 Nº 1 Páginas 17 - 27

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo: Definir o perfil epidemiológico e os principais determinantes de morbimortalidade dos pacientes cirúrgicos não cardíacos de alto risco no Brasil. Métodos: Estudo prospectivo, observacional e multicêntrico. Todos os pacientes cirúrgicos não cardíacos admitidos nas unidades de terapia intensiva, ou seja, considerados de alto risco, no período de 1 mês, foram avaliados e acompanhados diariamente por, no máximo, 7 dias na unidade de terapia intensiva, para determinação de complicações. As taxas de mortalidade em 28 dias de pós-operatório, na unidade de terapia intensiva e hospitalar foram avaliadas. Resultados: Participaram 29 unidades de terapia intensiva onde foram realizadas cirurgias em 25.500 pacientes, dos quais 904 (3,5%) de alto risco (intervalo de confiança de 95% - IC95% 3,3% - 3,8%), tendo sido incluídos no estudo. Dos pacientes envolvidos, 48,3% eram de unidades de terapia intensiva privadas e 51,7% de públicas. O tempo de internação na unidade de terapia intensiva foi de 2,0 (1,0 - 4,0) dias e hospitalar de 9,5 (5,4 - 18,6) dias. As taxas de complicações foram 29,9% (IC95% 26,4 - 33,7) e mortalidade em 28 dias pós-cirurgia 9,6% (IC95% 7,4 - 12,1). Os fatores independentes de risco para complicações foram Simplified Acute Physiology Score 3 (SAPS 3; razão de chance − RC = 1,02; IC95% 1,01 - 1,03) e Sequential Organ Failure Assessment Score (SOFA) da admissão na unidade de terapia intensiva (RC =1,17; IC95% 1,09 - 1,25), tempo de cirurgia (RC = 1,001; IC95% 1,000 - 1,002) e cirurgias de emergências (RC = 1,93; IC95% 1,10 - 3,38). Em adição, foram associados com mortalidade em 28 dias idade (RC = 1,032; IC95% 1,011 - 1,052) SAPS 3 (RC = 1,041; IC95% 1,107 - 1,279), SOFA (RC = 1,175; IC95% 1,069 - 1,292) e cirurgias emergenciais (RC = 2,509; IC95% 1,040 - 6,051). Conclusão: Pacientes com escores prognósticos mais elevados, idosos, tempo cirúrgico e cirurgias emergenciais estiveram fortemente associados a maior mortalidade em 28 dias e mais complicações durante permanência em unidade de terapia intensiva.

ABSTRACT Objective: To define the epidemiological profile and the main determinants of morbidity and mortality in noncardiac high surgical risk patients in Brazil. Methods: This was a prospective, observational and multicenter study. All noncardiac surgical patients admitted to intensive care units, i.e., those considered high risk, within a 1-month period were evaluated and monitored daily for a maximum of 7 days in the intensive care unit to determine complications. The 28-day postoperative, intensive care unit and hospital mortality rates were evaluated. Results: Twenty-nine intensive care units participated in the study. Surgeries were performed in 25,500 patients, of whom 904 (3.5%) were high-risk (95% confidence interval - 95%CI 3.3% - 3.8%) and were included in the study. Of the participating patients, 48.3% were from private intensive care units, and 51.7% were from public intensive care units. The length of stay in the intensive care unit was 2.0 (1.0 - 4.0) days, and the length of hospital stay was 9.5 (5.4 - 18.6) days. The complication rate was 29.9% (95%CI 26.4 - 33.7), and the 28-day postoperative mortality rate was 9.6% (95%CI 7.4 - 12.1). The independent risk factors for complications were the Simplified Acute Physiology Score 3 (SAPS 3; odds ratio - OR = 1.02; 95%CI 1.01 - 1.03) and Sequential Organ Failure Assessment Score (SOFA) on admission to the intensive care unit (OR = 1.17; 95%CI 1.09 - 1.25), surgical time (OR = 1.001, 95%CI 1.000 - 1.002) and emergency surgeries (OR = 1.93, 95%CI, 1.10 - 3.38). In addition, there were associations with 28-day mortality (OR = 1.032; 95%CI 1.011 - 1.052), SAPS 3 (OR = 1.041; 95%CI 1.107 - 1.279), SOFA (OR = 1.175, 95%CI 1.069 - 1.292) and emergency surgeries (OR = 2.509; 95%CI 1.040 - 6.051). Conclusion: Higher prognostic scores, elderly patients, longer surgical times and emergency surgeries were strongly associated with higher 28-day mortality and more complications during the intensive care unit stay.

https://doi.org/10.5935/0103-507x.20200005 1048 downloads

12.

Impact of Lung Expansion Therapy Using Positive End-Expiratory Pressure in Mechanically Ventilated Patients Submitted to Coronary Artery Bypass Grafting
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Cordeiro, André Luiz Lisboa

; Carvalho, Sarah

; Leite, Maria Clara

; Vila-Flor, André

; Freitas, Bruno

; Sousa, Lucas

; Oliveira, Quetla

; Guimarães, André Raimundo

Brazilian Journal of Cardiovascular Surgery

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Dez 2019, Volume 34 Nº 6 Páginas 699 - 703

Resumo: En | Texto: En | PDF: En

Abstract Objective: To evaluate the impact of different levels of positive end-expiratory pressure (PEEP) on gas exchange in patients undergoing coronary artery bypass grafting (CABG). Methods: A randomized clinical trial was conducted with patients undergoing CABG surgery. Patients were randomized into three groups: Group 10, PEEP of 10 cmH2O; Group 12, PEEP of 12 cmH2O; and Group 15, PEEP of 15 cmH2O. After the randomization, all patients underwent gas analysis at three moments: (1) before lung expansion therapy (LET); (2) 30 minutes after LET; and (3) one hour after extubation. Results: Sixty-six patients were studied, of which 61.7% were men, with mean age of 64 ± 8.9 years. Patients allocated to Group 15 showed a significant improvement in gas exchange comparing pre- and post-expansion values (239±21 vs. 301±19, P<0,001) and the increase was maintained after extubation (278±26). Despite the use of high levels of PEEP, no significant hemodynamic change was evidenced. Conclusion: It is concluded that high levels of PEEP (15 cmH2O) are beneficial for the improvement of gas exchange in patients undergoing CABG.

https://doi.org/10.21470/1678-9741-2019-0016 319 downloads

13.

Behavior of Pulmonary Function after Hospital Discharge in Patients Submitted to Myocardial Revascularization
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Cordeiro, André Luiz Lisboa

; Silva, Letícia Gardênia Romualdo da

; Pinto, Milena Oliveira

; Araújo, Jaclene da Silva

; Guimarães, André Raimundo

; Petto, Jefferson

International Journal of Cardiovascular Sciences

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Abr 2019, Volume 32 Nº 2 Páginas 104 - 109

Resumo: En | Texto: En | PDF: En

Abstract Background: Coronary artery bypass grafting (CABG) is a type of surgery where there is a compromise in one or more coronary arteries, with the objective of restoring function to the areas that have been compromised in the heart, possibly leading to respiratory compromise and postoperative complications. The return time of the pulmonary function to the preoperative condition is still indeterminate in the literature. Objective: To describe the behavior of pulmonary function after hospital discharge in patients submitted to CABG. Methods: This is a prospective cohort study. Only patients undergoing MRI, whose lung function was evaluated preoperatively, at hospital discharge and 30 days after surgery, were evaluated. This evaluation consisted of maximum inspiratory pressure (MIP) and expiratory (MEP), vital capacity (VC) and expiratory flow peak (EFP). Results: A total of 30 patients were evaluated, of which 18 (60%) were males, mean age 62 ± 9 years. A reduction in lung function from preoperative time to hospital discharge was observed in all variables. There was improvement in MIP (88 ± 9 vs 109 ± 5, p < 0.001), MEP (67 ± 10 for 90 ± 8, p < 0.001) and EFP (310 ± 59 for 390 ± 32, p < 0.001), high for review. At the time of the review, no variables returned to their preoperative value: MIP (116 ± 5 for 109 ± 5, p = 0.43), MEP (111 ± 8 for 90 ± 8, p < 0.001), VC (45 ± 12 for 39 ± 7, p = 0.33) and EFP (430 ± 40 for 390 ± 32, p < 0.001). Conclusion: It is concluded that MRI surgery reduces lung function and is not reestablished after 30 days of the procedure. Being the expiratory muscular force and the peak of expiratory flow the most affected.

https://doi.org/10.5935/2359-4802.20180092 427 downloads

14.

Association of Respiratory Mechanics with Oxygenation and Duration of Mechanical Ventilation After Cardiac Surgery
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Cordeiro, André Luiz Lisboa

; Oliveira, Livia Freire de Lima

; Queiroz, Thaynã Caribé

; Santana, Verena Lourranne Lima de

; Melo, Thiago Araújo de

; Guimarães, André Raimundo

; Martinez, Bruno Prata

International Journal of Cardiovascular Sciences

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Mai 2018, Volume 31 Nº 3 Páginas 244 - 249

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Fundamentos: A ventilação mecânica (VM) e a circulação extracorpórea (CEC) estão associadas a um declínio da mecânica pulmonar que pode impactar as trocas gasosas. Objetivo: Avaliar o impacto da mecânica pulmonar sobre a duração da VM e trocas gasosas no pós-operatório de cirurgia cardíaca. Métodos: Estudo de coorte realizado com pacientes submetidos a cirurgia cardíaca. Todos os pacientes foram submetidos a avaliação da mecânica pulmonar (complacência estática e resistência das vias aéreas) e gasometria arterial assim que admitidos à unidade de terapia intensiva (UTI) e foram acompanhados até o momento da extubação e, em seguida, até a alta hospitalar. Para correlacionar as variáveis preditoras com o desfecho, foi utilizado o teste de Pearson. Valores de p < 0,05 foram considerados significativos. Resultados: O estudo incluiu 50 pacientes (46 mulheres, 52%), com idade média de 57,5 ± 13,5 anos. A duração da VM foi de 7,7 ± 3,0 horas, a complacência estática foi de 35,5 ± 9,1 cm H2O, a resistência foi de 6,0 ± 2,3 cm H2O, a duração média de estadia na UTI foi de 2,9 ± 1,1 dias e o índice de oxigenação foi de 228,0 ± 33,4 mmHg. Não houve uma correlação significativa entre a duração da VM e a complacência estática (p = 0,73), porém houve uma forte correlação entre a complacência estática e as trocas gasosas (r = 0,8, p < 0,001). Conclusão: A mecânica pulmonar apresenta forte correlação com as trocas gasosas e fraca correlação com a duração da VM no pós-operatório de cirurgia cardíaca.

Abstract Background: Mechanical ventilation (MV) and extracorporeal circulation (ECC) are associated with a decline in pulmonary mechanics that may affect gas exchange. Objective: To evaluate the impact of pulmonary mechanics on MV duration and gas exchange in the postoperative period of cardiac surgery. Methods: This was a cohort study in patients undergoing cardiac surgery. All patients underwent evaluation of pulmonary mechanics (static compliance and airway resistance) and arterial blood gas analysis upon admission to the intensive care unit (ICU) and were followed up until extubation and hospital discharge. Results: The study included 50 patients (46 women, 52%) with a mean age of 57.5 ± 13.5 years. The MV duration was 7.7 ± 3.0 hours, static compliance was 35.5 ± 9.1 cm H2O, resistance was 6.0 ± 2.3 cm H2O, mean length of ICU stay was 2.9 ± 1.1 days, and oxygenation index was 228.0 ± 33.4 mmHg. No significant correlation was found between MV duration and static compliance (p = 0.73), but a strong correlation was found between static compliance and gas exchange (r = 0.8 and p < 0.001). Conclusion: Pulmonary mechanics have a strong correlation with gas exchange and a weak correlation with MV duration after cardiac surgery.

https://doi.org/10.5935/2359-4802.20180018 3310 downloads

15.

Effect of Different Levels of Peep on Oxygenation during Non-Invasive Ventilation in Patients Submitted to CABG Surgery: Randomized Clinical Trial
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Cordeiro, André Luiz Lisboa

; Gruska, Caroline Aparecida

; Ysla, Pâmella

; Queiroz, Amanda

; Nogueira, Sarah Carvalho de Oliveira

; Leite, Maria Clara

; Freitas, Bruno

; Guimarães, André Raimundo

Brazilian Journal of Cardiovascular Surgery

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Ago 2017, Volume 32 Nº 4 Páginas 295 - 300

Resumo: En | Texto: En | PDF: En

Abstract Introduction: During and after coronary artery bypass grafting, a decline in multifactor lung function is observed. Due to this fact, some patients may benefit from non-invasive ventilation after extubation targeting lung expansion and consequently improved oxygenation. Objective: To test the hypothesis that higher levels of positive end expiration pressure during non-invasive ventilation improves oxygenation in patients undergoing coronary artery bypass grafting. Methods: A randomized clinical trial was conducted at Instituto Nobre de Cardiologia in Feira de Santana. On the first day after surgery, the patients were randomized: Group PEEP 10, Group PEEP 12 and Group PEEP 15 who underwent non-invasive ventilation with positive end expiration pressure level. All patients were submitted to analysis blood pressure oxygen (PaO2), arterial oxygen saturation (SaO2) and oxygenation index (PaO2/FiO2). Results: Thirty patients were analyzed, 10 in each group, with 63.3% men with a mean age of 61.1±12.2 years. Mean pulmonary expansion pre-therapy PaO2 was generally 121.9±21.6 to 136.1±17.6 without statistical significance in the evaluation among the groups. This was also present in PaO2/FiO2 and SaO2. Statistical significance was only present in pre and post PEEP 15 when assessing the PaO2 and SaO2 (P=0.02). Conclusion: Based on the findings of this study, non-invasive ventilation with PEEP 15 represented an improvement in oxygenation levels of patients undergoing coronary artery bypass grafting.

https://doi.org/10.21470/1678-9741-2016-0038 1108 downloads

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